Whether an individual physician is in a practice that uses telemedicine depends greatly on if that physician is a radiologist or a gastroenterologist. Specialty also significantly affects whether a physician uses telemedicine to interact with patients or with peers and which telemedicine modality is used.
That was a finding of a benchmark study by AMA researchers who looked at who is using telemedicine, how they are using it and what obstacles remain to its implementation.
A little more than 15 percent of physicians worked in a practice that uses telemedicine to interact with patients, while 11.2 percent worked in practices that use telemedicine to interact with other health care professionals, according to the study published in Health Affairs.
Telemedicine use is less common in smaller or physician-owned practices, the AMA survey of 3,500 physicians found, which suggests that cost of implementation is an impediment.
The AMA advocated for—and the Centers for Medicare & Medicaid Services has accepted—five new Current Procedural Terminology (CPT®) codes for 2019 that will allow physicians to be paid for their delivery of health care services using virtual technologies including remote patient monitoring (RPM) and e-consults.
These include three CPT codes for RPM and two for e-consults with another health care professional.
The AMA’s Digital Health Implementation Playbook offers the most efficient path for applying digital health solutions in practice including RPM. Download the Playbook to access best practices, lessons learned, and tools and resources designed to accelerate and achieve digital health adoption.
The Health Affairs findings are based on data from the 2016 Physician Practice Benchmark Survey of the AMA and provide the most complete picture yet on adoption of the technology.
Specialty determines use
The researchers found that specialists using telemedicine the most to interact with patients are:
- Radiologists—39.5 percent.
- Psychiatrists—27.8 percent.
- Cardiologists—24.1 percent.
Specialists whose practices are using telemedicine the least to interact with patients are:
- Allergists/immunologists—6.1 percent.
- Gastroenterologists—7.9 percent.
- Ob-gyns—9.3 percent.
Almost an entirely different set of specialists used telemedicine for interacting with other health care professionals. Specialists whose practices are doing this the most are:
- Emergency physicians—38.8 percent.
- Pathologists—30.4 percent.
- Radiologists—25.5 percent.
To assess interactions with patients, physicians in practices that used telemedicine were asked if it was used for diagnosing or treating patients, following up with patients, or managing patients with chronic disease. To assess interactions with peers, they were asked if it was used for having a specialty consultation or getting a second opinion. They were also asked which telemedicine modalities their practice used: videoconferencing, remote patient monitoring (RPM), or storing and forwarding data.
Videoconferencing is employed by the practices of 31.6 percent of emergency physicians and about 25 percent of psychiatrists’ and pathologists’ practices. Cardiologists and nephrologists are the biggest RPM users, while radiologists and pathologists are the biggest users of telemedicine’s data storing-and-forwarding function.
The study defines the term “telemedicine” to include a range of technologies to deliver medical services including remote patient-management services, e-consults and two-way interactive video. There is not a universally accepted definition of telemedicine, so it is important to determine how health insurance payers and policymakers define the term when considering integration of these options into practice.
For example, Medicare defines “telehealth” as “two-way, audiovisual, real-time interactions,” and the CPT Editorial Panel identifies CPT codes that private and public insurers cover using two-way audio video synchronous communications in an appendix and utilizes additional codes to described remote monitoring and e-consults.
